Professional Documents
Culture Documents
TO
NATIONAL LEVEL MEETING
OF PROJECT DIRECTORS OF
RURAL DEVELOPMENT
ANDHRA PRADESH
PRESENTATION ON
1.Community Managed Health &
Life Insurance
2.Total Financial Inclusion
3.Food Security
SANJEEVANI
Community Managed
Health Insurance
SANJEEVANI
Sanjeevani is a Community based
and Community managed Health
Welfare Scheme, promoted by Zilla
Samakhya, Vishakhapatnam.
This is an initiative to make
Healthcare Services accessible to
rural Self Help groups ( SHGs) and
to promote preventive Healthcare.
Good health is a pre-requisite to human productivity and the
Cumbersome Procedure
Uncertainty
of
coverage
of
financial shock from health care
expenses
Expulsion
of
pre-existing
deceases (Rural poor wont go
for regular check-up of deceases
Administration of the
Scheme
The scheme will be implemented
and administered by Zilla
Samakhya, in coordination with the
Mandal Samkhaya, and Village
Samakhyas.
Coverage and
Premium
1.
Features of the
Scheme
Out Patient Consultation
PHC level: consultation with lady doctors once
in a week free of cost
Network Hospital (NWH): consultation free of
cost
2. Diagnostics:
Basic diagnostics will be done at PHC free of
cost
Diagnostics at NWH will be done at a fixed
discounted rate.
3. Quality Medicine
Free of cost at PHC level
Features of the
Scheme
Surgeries Covered
The scheme covers more than 1500 surgeries,
including all categories of complex and
common surgeries, such as
1. OBG includes normal delivery, LSCS and
Hysterectomy
2. General Surgery
3. Gastroenterology
4. Orthopaedics includes fracture surgeries
5. Genito-Urology
6. Endocrinology
7. ENT
The Team
Case Manager Role and
Responsibilities
1. Coordinate the referral system of the
patient
2. Regularly visit the Network Hospitals,
at least once a week, and ensure that
the terms and benefits of the scheme
are being properly followed.
3. Regularly interact with the beneficiaries
of the scheme undergoing treatment for
feedback.
4. Inform the Implementing Agency (ZS)
about any non-conformance, if any, and
The Team
Case Manager Role and
Responsibilities
6. Randomly verify the operated cases
for authenticity of the members.
7. Verify the authenticity of every case
received
for pre-authorization
and
Medical
Officer
Role and Responsibilities
submit report to ZS.
1. Approval of Preauthorization based on
necessity of treatment
2. Liaison with NWH
3. Quality monitoring of service providers
Process
of
Treatment
Availing
Beneficiary approaches VO
Representative
Medical
treatment
Free OPD
Consultation
Admission for
Surgery
Intimation to
TPA/ZS by NWH
Pre-Authorizationfrom TPA/ZS
CASHLESS
Hospitalization
Member signs on
the Claim Form
Discharge
Claims Flowchart
Receipt of claims
From NWH
Incomplete
Document
verification
Communication To Hospital
Complete
Claim ID Generation
Communication To Hospital
Approved Claims
Collection of DD
Dispatch o hospital
Outward
Progress
1. Total House Holds Covered sofar
: 32,840
: Rs.260/-
: 17
: 27
: 650
Impact
Free OP
In Networking Hospitals
: 11,325
: 4,460.
Diagnostic Tests
20% discount on diagnostic tests
Amount benefited
Rs.1,51,860
Drugs
10% discount on drugs
Amount benefited
Impact
Medical Cases treated
Physical
373
Amount
Rs. 9,12,465
277
Amount
Rs. 14,37,664
Medical
Cases
Expenditure (From
May to December
2007)
Month
No. of Cases
Amount
May 07
3,000
June 07
19
30,967
July 07
58
1,27,800
August 07
26
1,12,300
September 07
54
1,05,500
October 07
74
1,49,272
November 07
60
1,30,908
December 07
81
2,52,718
TOTAL
373
9,12,465
Medical Cases
Treated
Type of Disease
No. of Patients
% of total cases
Cerebral Malaria
185
68%
Jaundice
76
28%
Normal Delivery
53
19%
Typhoid
27
10%
22
8%
TOTAL
273
Medical Cases
Treated
Surgical
Cases
Expenditure (From
May to December
2007)
Month
No. of Cases
Amount
May 07
34,231
June 07
16
1,00,300
July 07
46
3,33,800
August 07
28
1,14,986
September 07
25
1,31,090
October 07
36
2,27,595
November 07
67
3,28,050
December 07
54
1,67,612
TOTAL
277
14,37,664
Surgical Cases
Treated
Type of Surgery
No. of Patients
% of total cases
Hysterectomies
65
24%
Orthopedic
106
38%
Caesarian Section
52
19%
Hernia Hydrosols
34
12%
20
7%
TOTAL
273
Surgical Cases
Treated
DRDA
SERP
Objective
DRDA
SERP
Need
Rural poor household having no access to formal Insurance
services to cover risks.
Very limited awareness about insurance related risk
mitigation options amongst the poor.
High premium coupled with tedious & time consuming claim
settlement process.
Participatory community based insurance delivery
mechanism meets the needs of the poor more effectively
than the provider managed insurance delivery.
DRDA
SERP
Evolution
Initiated dialogue with community on need for community
DRDA
SERP
26,15,540
Rs.26.68 Crores
Rs.21.71 Crores
7215
6133
Natural Deaths
Accidental Deaths
Claims settled sofar
Natural Deaths
Accidental Deaths
Claim amount settled
DRDA
: 6459
: 756
: 5515
: 618
:
Rs.15.73 Crores
SERP
Women
covered
Claims
received
Adilabad
93394
200
124
4675000
Ananthapur
129776
187
137
4025000
Chittor
336163
338
278
9340000
East Godavari
134000
306
236
8080000
West Godavari
153786
322
271
9130000
Kurnool
46319
141
103
3400000
Karimnagar
336946
59
16
320000
Khammam
109326
605
548
17830000
Kadapa
122701
656
600
20690000
Mahaboob Nagar
26028
174
131
3900000
DRDA
Claims
settled
Claim amount
settled
SERP
Women
covered
Claims
received
Claims
settled
Claim amount
settled
Medak
153217
1788
1585
5077250
Nizamabad
122500
318
270
9100000
Prakasam
66419
224
177
6310000
Vizianagaram
171000
648
593
18400000
Visakhapatnam
85632
235
193
7369000
Nellore
109459
209
173
6190000
Srikakulam
138348
299
256
8680000
Warangal
207359
309
274
9220000
Gunturu
73167
197
148
5575000
TOTAL
2615540
7215
6133
1573250
DRDA
SERP
DRDA
SERP
SERP
DRDA
SERP
2006-2007
Affordable premium
Immediate claim settlement by Zillah
Samakhya.
357 Claims settled so far against 390 claims
received.
Rs. 89.10 Lakhs Amount
distributed towards
2007-2008
claim
193 Claims settled so far against 235 claims
settlement.
received.
SERP
Objective
To address all the financial needs of all
households
Analysis of financial
needs of the poor
minor
school education
Children education
higher education
Marriage purposes
Income generation Activities
Long term investment on land
Food
House
Working capital
Health
Health
Marriage
Children education
Landpurchase/development
Higher education
Debt
or/and
The Result .
Loan
amount
from
money
leners/mfi
in each
SHG
(average)
1,50,000
Rate of
interest
Interest
per month
paid by
SHG to
money
lenders/
mfi
Interest
per
annum
paid by
SHG
No of
SHGs in
the
district
(average)
Total
interest
amount
paid by
SHGs per
annum in
a district
to money
lenders/
mfi
36
4,800
57,600
40,000
230
crores
150 crores
PLAN OF ACTION
Identification of village
Having good track record in SHG-Bank
Linkage
Having SHGs which are following best
practices
Having good book keeping practices in SHGs
Having SHGs with Poorest of the Poor and
SCs and STs
Identification shall be done in consultation
with CBRM/Mandal Samakhya
Pre-conditions
Facilitating the SHGs to enable them to
be good SHGs - at least THREE months
preparatory work has to be done in the
village
All the members of each SHG shall be
educated on financial inclusion
Book-keeping shall be strengthened
Good Monitoring mechanism shall be
positioned
-weekly savings
-weekly internal lending of small debts,
-weekly recovery of small debts,
-book keeping for every 4 SHGs, ONE book keeper
-need based lending,
-awareness among all members,
-self-preparation of MCP by the SHG
Positioning of anchor person for the branch
Bank-branch name:
VO Name
Village Name:
Mandal Name:
Sl
no
Name
of the
memb
er
Socia
l
Staus
(SC/S
T/BC/
OC)
Eco
Stat
us
(PO
P/P
oor/
NP)
MFI
Othe
rs
Tota
l
IGA
Unit
Investme
nt
Social needs
Total
Nee
d
Requir
ed
amoun
t
TOTAL
TFI Plan total:
Outstanding bank-linkage:
Grand Total:
Total
Grand
Total
Repayment
Ins
amou
nt
Number
of Ins
23
50
1000
23
50
5000 115
50
5000
23
10000 230
50
10000
23
1000
Principal
Ins
amo
unt
Number
of Ins
Income
Ins
amou
nt
Numbe
r of Ins
1000 1200
40
30
150
55
500
38
Mem
Loan
Sources
INCOME
monthly
crop
Repayment
Total
Monthly
Principal
int
Tot
No of
inst
Crop
(prin)
X1
30000
dairy
2000
24000
750
450
1200
40
X2
45000
Ag land,
3000
7000
43000
1320
280
1600
5000
35
X3
28000
X4
54000
X5
47000
X6
15000
X7
25000
X8
40000
X9
36000
10
X10
45000
65000 385000
10350
3650
14000
30000
REPAYMENT
TO
BANK
6000
3650
SURPLUS IN SHG
4350
TOTAL
365000
320000
60
30000
Year-wise distribution
of loan (taken from
money lenders)
st
60,000 1 yr
TOTAL
60,000
2nd year
60,000
45,000
rd
30,000 3 year
30,000
4th year
15,000
150,000
Loan
from
money
lender or
MFI
Rat
e of
inte
rest
Inter
est
per
mont
h
10000
36
300
Loan
from
bank
Ra
te
of
int
ere
st
Inte
rest
per
mon
th
differ
ence
betwe
en
ML/
mfi
and
bank
10000
73
227
EMI of
the
bank
per
month
(princi
pal)
230
No
of
inst
alm
ent
s
Rate of
reimbu
rsement
of
PAVAL
A
VADDI
Amoun
t of
PAVAL
A
VADDI
for
every
SIX
months
No
of
SI
X
mo
nth
ly
spe
lls
Total
amount
of
PAVAL
A
VADDI/
per
membe
r
44
287
2083
Monthly payments..
To members
To Village Organisation
Monitoring
Before TFI
After TFI
Bank Linkage
Additional income
Bank Linkage
Additional income
Bank Linkage
Additional income
Bank Linkage
Additional income
320
5218
Rs.173.43 Crores
2007-08
Total Villages covered
Total SHGs covered
:
:
1356
24456
Rs.717.48 Crores
FOOD SECURITY
The reason
The availability of rice under PDS is on an
average 15 kg/month per family
The requirement of rice for an average size
family in rural area is 50 kg/month
The gap is on average 35 kg/month
The 35 kg/month is used to be procured from
open market
2/3rd of the food security of the poor becomes
vulnerable and subject to market fluctuations
Objectives
To attempt to minimise the Food Gap in POP and the
Poor
To facilitate for the emergence of Total Food Security
to the target poor at household level
To minimize the rate of exploitation in consumption
expenditure made by the poor.
To provide access to good quality and accurate quantity
of rice by the target poor through cheaper rates
TO correlate the nutritional improvement in the
pregnant women and children with food security
initiative
The Process
Sitting with the members of each SHG
Analyse the consumption pattern
Arriving at the rate of losses in respect of
purchase of each commodity
Find out of the requirement of each
member
Implementation in few VOs in each
Mandal.
Implementation process-the
distribution
The distribution committee will distribute to
SHG leaders.
The SHG leaders will distribute to each
member on the same day.
At every stage of distribution, the
acknowledgements will be collected.
Time line
First of every month SHG requirement is
collected,
2nd to 4th of every month VO level
requirement is collected,
5th to 10th of every month, distribution of
rice from the mill to the VO, VO to SHG,
SHG to members.
Procurement
Recovery
If it is monthly recycling,
the recovery will be
completed from the
members within 3 weeks
If it is 3 month/6 month
model, recovery will be
completed within 5 months
In monthly model, the
instalments will be on
weekly basis
In 6 monthly model the
instalments will be on
monthly basis
Funds
The corpus of the SHG
The CIF from the VO/MS
The cash credit limit by the bank to the VO
Inclusive approach
Within the SHG, the food
security plan is prepared by
the SHG taking each
members requirement ,
particularly the POP- both
quality and quantity and the
nature of food grains
The repayment instalments
will be fixed as per the
convenience of the
members
The small loan provision is
available in the SHG to the
member in case she is not
able to repay that instalment
A poor women in
Dondapadu Village of
Thulluru Mandal Cooking
Rice
The progress
Total no of VOs
27,000
No of VOs covered
6827
No of SHGs covered
1,83,241
No. of house-holds covered 19,67,437
Quantity of rice
68,860 MT/month
-- 816,323 MT/year
Total turnover per year -- 898 crores
Total cost of the project Rs.68 crores
Name of the
House Hold
.(1)
.(2)
Adul
ts
Child
ren
per
day
requi
reme
nt
.(3a)
.(3b)
.(4)
Mont
hly
requir
emen
t
Consumption
Before RCL
After RCL
Defi
cit
(in
Kgs)
% of
defic
it
per
day
per
mont
h
.(5)
.(6a)
.(6b)
.(7)
Defi
cit
(in
Kgs
)
% of
deficit
per
day
per
mont
h
.(8)
.(9a)
.(9b)
.(10)
.(11)
Kalva China
Mariamma
60
1.6
48
12
20
1.8
54
10
Kalva Peda
Mariamma
1.8
54
1.5
45
16.
7
1.7
51
5.6
Kukkamudi
Jyothi
60
1.6
48
12
20
1.8
56
10
Macherla
China
Venkaiah
90
2.6
78
12
13.
3
2.8
84
6.7
Kalva
Seshamma
60
1.6
48
12
20
1.8
54
10
Dasari
Masthanamma
90
2.6
78
12
13.
3
2.8
84
6.7
Source of Supply of Rice to the Poorest of the Poor & the Poor
Source of Supply
Before RCL
Sl.
No.
.(1)
Name of the
House Hold
.(2)
After RCL
FP
shop
s
Kirana
Shops
Paddy
Milling
Total
FP
shops
Kirana
Shops
Paddy
Milling
RCL
Total
.(3a)
.(3b)
.(3c)
.(3d)
(4a)
.(4b)
.(4c)
.(4d)
(4e)
Kalva China
Mariamma
20
28
48
20
34
54
Kalva Peda
Mariamma
16
29
45
16
35
51
Kukkamudi Jyothi
25
23
48
25
31
56
Macherla China
Venkaiah
30
48
78
30
54
84
Kalva Seshamma
26
21
47
26
28
54
Dasari
Masthanamma
27
51
78
27
57
84
The Impact
Reduction in Food Gap
and increase in food intake
by the poor
Reduction in price
Increase in real income
Increase in quality
Ensuring Total Food
Security
Caring for the aged,
destitute and pregnant
women
Capital formation in VOs
and MSs